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  1. Simon Rolin
  1. Correspondence to Dr Simon Rolin, ST7 Respiratory and General Internal Medicine, Heart and Lung Unit, South Devon Healthcare NHS Foundation Trust, Torbay Hospital, Newton Road, Torquay, Devon TQ2 7AA, UK; drsrolin{at}

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The risk of overdiagnosis in lung cancer screening

Screening for lung cancer has been proposed on the principle that tumours will be detected at a smaller size and earlier stage, resulting in a reduction in lung cancer mortality. This study (JAMA Intern Med doi:10.1001/jamainternmed.2013.12738) reviewed data from the National Lung Screening Trial to calculate the rates of excess cancers in the LDCT versus CXR arm for all lung cancers and various histological subtypes. The probability was 18.5% that any lung cancer detected by screening with LDCT in the National Lung Screening Trial was an overdiagnosis. Overdiagnosis represents an important potential harm of screening because it incurs unnecessary cost, anxiety and morbidity associated with cancer treatment.

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